Visual Diagnosis

Case: A 6-year-old boy is brought in to the ED by his grandmother after he “rubbed his eyes while eating eggs.” She denies recent trauma or other exposures to the boy’s eye.

Photo Credit: © Ee Tay, MD, and Sylvia Garcia, MD.

Diagnosis:

This patient has chemosis.

Chemosis is edema of the conjunctiva. This may occur in the setting of allergies, trauma, conjunctivitis, recent eye surgery, or constant eye rubbing. Other less common causes include hyperthyroidism, lupus, or obstruction of lymphatic or venous drainage. Management includes treating the underlying cause of the chemosis.

Clinical Practice Pearls:

• A cool compress may decrease swelling and discomfort.
• Consider eye lubricant if the patient is unable to close the eye due to swelling.
• Counsel patients to avoid contact lenses in the presence of swelling.

Additional Reading:

• Kalin NS, Orlin SE, Wulc AE, et al.Chronic localized conjunctival chemosis. Cornea. 1996;15(3):295-300.